U.S. Coast Guard Terminated Contract with Epic for EHR Implementation

The U.S. Coast Guard has discontinued an Integrated Health Information System (IHiS) implementation project, which is an expansion of an electronic health record (EHR) implementation project as part of a contract awarded to Verona, Wis.-based Epic Systems in 2010, a USCG representative said.

The Coast Guard is pursuing an alternative EHR system, and, in the interim, Coast Guard physicians are continuing to use paper-based records, "without interruption of service to members and dependents," the USCG spokesperson, Alana Ingram, public affairs officer, said.

Politico posted an article Friday that the Coast Guard terminated its contract with Epic to implement a commercial EHR system, and, as a result, Coast Guard doctors have reverted to using paper documents.

Ingram, public affairs officer, media relations branch, Office of Governmental and Public Affairs, U.S. Coast Guard Headquarters, confirmed that the EHR implementation project had been discontinued in an email to Healthcare Informatics Friday. An Epic spokesperson also confirmed, in an email, that the contract with the Coast Guard was not continued in September 2015.

Ingram stated, "In 2010, the Coast Guard began pursuing a commercial off the shelf (COTS) product for electronic health records (EHR). Over time, the EHR project expanded into a Service-wide Health, Safety, and Worklife (HSWL) IT re-engineering project known as the Integrated Health Information System (IHiS). This expansion of scope increased the cost and technical complexity of the project."

Ingram further stated, "In 2015 the Coast Guard determined there were significant risks associated with continuing the IHiS project and decided not to exercise further contract options. The decision was driven by concerns about the project's ability to deliver a viable product in a reasonable period of time and at a reasonable cost. As a result of the analysis that led to the discontinuation of the project, various irregularities were uncovered, which are currently being reviewed. There is also an ongoing effort to review and closeout the relevant contract matters and determine the final status of any outstanding invoices, payments or potential claims by the Coast Guard."

Ingram also stated that the Coast Guard has "reset its pursuit of an EHR system and will use its formal acquisition process to update requirements and conduct a detailed analysis of possible alternatives."

"We do not yet have a projected timeline for the deployment of an EHR system. The Coast Guard is committed to ensuring proper management and oversight of the acquisition process for a new EHR system," she said.

"In the interim, the Coast Guard will continue the use of paper-based records without interruption of service to members and dependents," Ingram also said.

According to an annoncement about the Epic deal back in 2010, the Coast Guard's previous EHR system lacked the ability to meet current federal requirements for an EHR that is standards-based and capable of exchanging health data. It also lacked basic EHR features such as clinical decision support, population health reporting, and patient scheduling portals. The plan was for the new EHR system to replaces a version of a Defense Department system that includes the Composite Health Care System (CHCS), Provider Graphic User Interface (PGUI), and Armed Forces Healthcare Longitudinal Application (AHLTA).

When the Epic deal was announced in 2010, the Coast Guard operated 43 ambulatory clinics across six time zones and remote sickbays on land and afloat. All land-based clinics and sickbays are connected to the Coast Guard Digital Network (CGDN) through which they access the Medical Information System.

Just last August, as reported by Healthcare Informatics, the Coast Guard tapped the HealthShare health informatics platform from the Cambridge, Mass.-based InterSystems as its interoperability platform as it looks to have a comprehensive EHR across the department’s disparate systems. HCI Managing Editor Rajiv Leventhal reported, “As the Coast Guard transitions from legacy systems to a commercial EHR solution, HealthShare provides standards-based interoperability to unify health information from civilian and Coast Guard care providers, officials say.”

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